When you hear you child's tummy rumble, you should appreciate what a sophisticated piece of machinery the human body is. Most of those noises, despite sometimes being startling or unpleasant-sounding, are quite normal. These sounds are made by your child's intestines, the large organs that process the food she eats. As the intestines are long, hollow pieces, you should expect normal bowel sounds like liquid flowing through water pipes as their work echoes throughout your child's abdominal cavity. If your child eats normally, has regular bowel movements and isn't complaining of pain or vomiting, the sounds you hear from her belly are likely a healthy sign that her digestive system is simply working. To the contrary, if additional symptoms accompany noises you've never heard before or if you don't hear any noise at all, even with your ear pressed to her stomach, contact your pediatrician immediately.
When your child's stomach is empty, when she's hungry and even when she's simply knows she's about to eat, her stomach makes contractions that squeeze air around. This process makes those noises you might hear as a stomach rumble. Sears says these rumblings, along with belching, vomiting and occasional retching are "occupational hazards" or a hard-working, but normal sounding gut. Because your child swallows air and saliva many times throughout the day, the upper end of her intestines often "kick back" some of the air. You can expect rushing, murmuring, tinkling, gurgling waves of sound from you child's belly every 5 to 15 seconds, and they may last a few to several seconds. It's normal to hear the most activity before and after eating.
The Air Out There
In addition, additional internal gases are produced by fermentation processes happening in her lower intestines, causing sounds that can exit in the other direction. For example, you can expect normal sounds after your child eats foods like beans. What happens is the normal bacteria living in her intestines feed on the sugars produced as her body breaks down certain starchy foods. Gas is a byproduct of her bacteria's own digestive process. It may start with funny noises in her belly, and some of that air will travel up and out, and some will travel down and out. You might also expect eating a very large meal to cause more gas, and thus, more noise.
Sometimes the sounds you hear from your child's lower belly indicate something else is going on. In normal cases, when her bowel sounds are reduced in loudness, tone or regularity, that means intestinal activity has slowed. This is normal during sleep, but abnormal if the reduction in sound occurs more often even after eating. It could mean constipation or a bowel obstruction, often sounding like water tinkling through a pipe. On the other hand, hyperactive bowel sounds, especially high-pitched noises, mean your child is experiencing an increase in intestinal activity. This is normal with diarrhea and just after eating, but abnormal when accompanied by other symptoms like pain. High-pitched noises also often result from food allergies and stress. Very high-pitched noises may also be an early sign of obstruction. Sloshing or rippling noises may indicate inflammation in the bowel. If no sound is heard after eating, your child could be experiencing an intestinal rupture or strangulation of the bowel. Always seek medical help immediately if your child experiences difficult-to-explain bowel sounds.
Your child's health-care provider will often use bowel sounds in conjunction with a physical exam to diagnose your child. The pediatrician will listen with a stethoscope. The sounds, if highly specific, can indicate where an obstruction is located. What are thought to be abdominal sounds have also helped doctors diagnose appendicitis and lower lung issues confused as bowel issues. Depending on what your child's doctor hears and what results from the physical exam, additional tests might be in order if either is abnormal.
Is This an Emergency?
- Hospital Physician: Acute Abdominal Pain
- European Society of Paediatric Urology: Paediatric Physical Assessment Within Continence Care -- Bowel and Bladder
- BestBETs: How Useful Are Bowel Sounds?
- "Case Based Pediatrics For Medical Students and Residents"; Chapter X.3. Appendicitis; January 2002
- MedlinePlus: Intestinal Obstruction
- "Digestive Surgery"; How Useful Are Bowel Sounds in Assessing the Abdomen?; Yuqi Gu;